SECTVC - Fire Extinguisher Incidents

INCIDENT INVESTIGATION ASSIGNMENT INSTRUCTIONS
Fire Extinguisher Incidents – SECTVC2020

DOCUMENT NUMBER:
DATE OF INCIDENT:

CATID:

FOLLOW-UP REQUESTED

HAZARD ANALYSIS

SECT 15

PRIMARY CONTACT:
BACK-UP CONTACT:

Richard Wright, 301-504-7598, [email protected]
Valery Ceasar, 301-504-7851, [email protected]

ASSIGNMENT MESSAGE:
Please investigate this Fire Extinguisher incident as a telephone IDI. Collect the information needed to answer the
questions listed below. A full narrative write up for this IDI is not necessary. Because there is no narrative required, if
the consumer verbally grants permission to disclose his/her name, include such statement on Exhibit 1-Contact page.
Please include: the list of exhibits, the Contact page (with name of victim, if applicable) as the first exhibit, the
completed questionnaire (attached) as the second exhibit, along with any other documentation that may be collected
during this IDI.
Obtain the answers to the following questions regarding the attached fire extinguisher incident.
Answer the questions below on the attached questionnaire and include the questionnaire as Exhibit 2 of this IDI.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

What was the manufacture/brand/model/date code of the fire extinguisher?
When did the consumer purchase the fire extinguisher?
Where did the consumer purchase the fire extinguisher?
How long did the consumer have the extinguisher before using the unit?
When did the residential fire occur?
Did the consumer attempt to use the fire extinguisher to put out the fire?
If the consumer attempted to use the fire extinguisher to put out the fire, did the fire extinguisher work?
If the fire extinguisher did not work, what failed when attempting to use the fire extinguisher?
Was this the only fire extinguisher in the residence?
If there was another fire extinguisher in the residence was it the same manufacturer/brand, etc.
If the consumer attempted to use the second fire extinguisher to put out the fire, did the fire extinguisher work?
Did the consumer notify anyone of the fire and the failure of the fire extinguisher to operate? The
manufacturer? The consumer’s attorney? The fire marshal and/or fire department?
13. Was anyone injured/suffered smoke inhalation/died as a result of the fire?
14. Was the consumer aware of the fire extinguisher recall?
15. Did the consumer notify the Firm that they owned a fire extinguisher?
16. Was the consumer’s unit one of the units included the recall?
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Area below will be completed in Data Systems _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Person(s) to Contact:
Task Number:
Assigned to:

CPSC FORM 324A

Date:
Processed by: lew

IDI Task Number

Exhibit Number 2
Fire Extinguisher Incidents Questionnaire

1.

What was the manufacture/brand/model/date code of the fire extinguisher?

2.

When did the consumer purchase the fire extinguisher?

3.

Where did the consumer purchase the fire extinguisher?

4.

How long did the consumer have the extinguisher before using the unit?

5.

When did the residential fire occur?

6.

Did the consumer attempt to use the fire extinguisher to put out the fire?

7.

If the consumer attempted to use the fire extinguisher to put out the fire, did the fire extinguisher work?

8.

If the fire extinguisher did not work, what failed when attempting to use the fire extinguisher?

9.

Was this the only fire extinguisher in the residence?

10. If there was another fire extinguisher in the residence was it the same manufacturer/brand, etc.

CPSC FORM 324A

12. If the consumer attempted to use the second fire extinguisher to put out the fire, did the fire extinguisher work?

13. Did the consumer notify anyone of the fire and the failure of the fire extinguisher to operate? The
manufacturer? The consumer’s attorney? The fire marshal and/or fire department?

14. Was anyone injured/suffered smoke inhalation/died as a result of the fire?

15. Was the consumer aware of the fire extinguisher recall?

16. Did the consumer notify the Firm that they owned a fire extinguisher?

17. Was the consumer’s unit one of the units included the recall?

CPSC FORM 324A